Nearly empty pipeline

Infections caused by resistant bacteria have occurred ever since antibiotics were first introduced in clinical practice. During the first decades of the antibiotic era, the emergence of resistant bacteria was balanced by the repeated discoveries of new antibiotics. But then the innovation of antibiotics slowed down.

For many years there have been very few new drugs in the antibiotic pipeline. In fact, the latest new antibiotic class to reach the market was discovered already in 1987. During the same period, resistance rates to available old antibiotics have increased rapidly as a result of massive consumption and spread of resistant strains. For certain bacterial infections, few or no effective antibiotic remain. The situation is particularly troublesome for Gram-negative bacteria, e.g. Pseudomonas, Klebsiella, E. coli and Salmonella, that are frequent causes of urinary tract infections, bloodstream infections and hospital-acquired infections. It is as if we are running out of antibiotics. The consequences in terms of treatment failures, increased mortality rates and higher costs are becoming more and more obvious, which has attracted a lot of attention to the problem in recent years.

The timeline below shows when the different major antibiotic classes were discovered. “The discovery void” refers to the period from 1987 until today, as the last antibiotic class that has been successfully introduced as treatment was discovered in 1987.